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September 15, 2025

Delaware Approves 125% Medicare Reimbursement Rate for E&M Procedures

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On September 9th, Healthesystems attended the Delaware Workers’ Compensation Oversight Panel meeting, where members approved a 125% Medicare reimbursement rate for Evaluation and Management (E&M) codes.

This change follows Senate Bill 164, which authorizes a one-time 3% aggregate increase in workers’ compensation medical costs. This adjustment aims to address longstanding underpayment for E&M services and improve physician participation, as low reimbursement has contributed to provider shortages. By giving providers more incentive to participate in the workers’ comp system, this change could support better access to timely and quality care for injured workers.

The updated rates will take effect on January 31, 2026, and are expected to enhance access to care for workers’ compensation patients.

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